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Liposuktionskürettage versus Botox® bei axillärer Hyperhidrosis

Eine prospektive Studie der Lebensqualität

Liposuction curettage versus Botox for axillary hyperhidrosis

A prospective study of the quality of life

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Zusammenfassung

Hintergrund

Axilläre Hyperhidrosis ist eine Sekretionsstörung der Schweißdrüsen. Konservative Behandlungsformen sind meist ineffektiv. Tumeszenzliposuktion und subkutane Kürettage (TLK) zerstören die Schweißdrüsen, während Botox®-Injektionen die cholinerge Übertragung hemmen.

Material und Methode

Aus einer Gruppe von insgesamt 88 Patienten wurde bei 47 Patienten eine TLK durchgeführt und bei 41 Patienten Botox® verwendet. Die Auswirkungen der beiden Therapien auf die Lebensqualität wurden durch einen spezifischen Hyperhidrosisfragebogen gemessen und mit gravimetrisch erfassten Schweißmengen korreliert.

Ergebnisse

Nach 6 Monaten zeigten sich signifikant veränderte Gravimetriewerte von 52±41 mg/min bei TLK-Patienten vs. 78±87 mg/min der Botox®-Gruppe; 91% (TLK) und 98% (Botox®) waren mit dem Ergebnis zufrieden.

Schlussfolgerung

Einer belastenden postoperativen Phase der TLK als 1-maligem Eingriff steht bei Botox®-Injektionen deren notwendige Wiederholung gegenüber. Beide Methoden sind hinsichtlich der Effektivität und der Komplikationsraten anderen, radikaleren chirurgischen Maßnahmen vorzuziehen. Beide Therapiearten führen zu einer erheblichen Verbesserung der Lebensqualität.

Abstract

Background

Axillary hyperhidrosis is a dysfunction of the secretion of sweat glands. Conservative treatment modalities are mostly ineffective. Liposuction combined with subcutaneous curettage (TLC) destroys the sweat glands, while Botox injections inhibit the cholinergic transmission.

Material and method

Of a total of 88 patients, TLC was carried out in 47 and 41 patients received intradermal Botox injections. The effect of both forms of treatment on the quality of life was assessed using a specific hyperhidrosis questionnaire and was correlated with sweat volumes measured by gravimetry.

Results

Follow-up after 6 months showed significantly changed sweat volumes of 52±41 mg/min of TLC patients versus 78±87 mg/min in the Botox group. In the TLC group 91% and in the Botox group 98% were satisfied with the result.

Conclusion

The stress of a single surgical intervention is to be weighed against the necessary repetitive application of multiple Botox injections. Both methods are superior to other, more radical surgical methods in terms of efficacy and complication rates. Botox and TLC lead to a significant improvement of the quality of life.

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Authors and Affiliations

  1. Zentrum für Schwerbrandverletzte mit Plastischer Chirurgie, Unfallkrankenhaus Berlin Marzahn, Berlin, Deutschland

    C. Ottomann  & B. Hartmann

  2. Plastische Chirurgie und Handchirurgie, DRK-Kliniken Berlin/Westend, Spandauer Damm 130, 14050, Berlin, Deutschland

    J. Blazek &  T. Muehlberger FRCS

Authors
  1. C. Ottomann
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  2. J. Blazek
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  3. B. Hartmann
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  4. T. Muehlberger FRCS
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Correspondence to T. Muehlberger FRCS.

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Ottomann , C., Blazek, J., Hartmann, B. et al. Liposuktionskürettage versus Botox® bei axillärer Hyperhidrosis. Chirurg 78, 356–361 (2007). https://doi.org/10.1007/s00104-006-1288-y

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  • DOI: https://doi.org/10.1007/s00104-006-1288-y

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